CELINA - Rising costs and an aging fleet has prompted the need for a hefty increase in ambulance rates for 2014.

Charges for squad runs by the Mercer County Emergency Medical Service will increase in January up to 150 percent, based on the type of service required. Rates have been unchanged since January 2009, officials said.

"They definitely need to increase," county commissioner Jerry Laffin said Thursday before the three-man board unanimously approved the new fees.

The charge for basic life support will increase from $425 to $650, a spike of nearly 53 percent. Other hikes are advanced life support, $500 to $800; advanced life support II, $600 to $1,000; and medical assist, $100 to $250. Mileage costs also are rising from $9 to $12 per mile.

The current fees - which pay for fuel, equipment, staff training and other expenses - are lower on average than those charged in neighboring areas, officials said. The cost for basic life support service in the region, for example, ranges from $450 in St. Marys to $680 in Greenville, according to information from the county EMS.

Mercer County dispatches squads and volunteer emergency responders in the villages of Coldwater, St. Henry and Rockford. A contract for squad service also is annually penned with the city of Celina, which operates a full-time, paid staff of paramedics.

Commissioners first discussed the possibility of raising rates on Tuesday after receiving a letter from county EMS Coordinator Steve Beougher following an emergency meeting of the EMS advisory board Dec. 18. Beougher in his letter dated Dec. 20 listed his rate recommendations and those of the advisory board, which were higher and subsequently adopted by commissioners.

Commissioners tabled the action Tuesday to gather more information on the agency's finances. According to the most recent fiscal report ending Nov. 30, the EMS's year-to-date receipts are $750,897 and expenses are $918,547. Carryover into 2013 totaled $649,214; the carryover for 2014 has fallen to about $241,000.

EMS also annually collects a $2.50 per capita fee from each political subdivision - city, villages and townships - to support general operations. Beougher on Thursday said the agency opted against increasing that fee, which was raised from $2 in 2003.

"That basically causes people who don't use the service to pay extra," he explained.

Beougher said to operate efficiently and professionally the agency must increase revenues.

"I saw that we were going backwards instead of forwards. We're not keeping up with the times," he said. "There's new and better equipment available every day ... equipment our people need to do the best job they can do."

Officials also noted that six of the agency's 10 ambulances are more than 14 years old. Eight of the vehicles are on call daily and two are used as spares. One of the squads this year was rehabilitated to save money; the cost of a new ambulance is more than $100,000, Laffin said.

Beougher said he realizes that money is tight for many county residents.

"We try not to pressure people," he said.

The agency bills Medicaid, Medicare and private insurance companies for services and often must settle for the amount reimbursed. By law, EMS cannot contract with private companies who have the option of reimbursing EMS or the patient.

Past due bills are given to a private bill collection agency, she said. Hinkle did not have available data showing the percentage of unpaid accounts.

Beougher said the problem of nonpayment is growing.

"The money is slowly coming in now and I'm not sure why. I think it's just the way people prioritize the bills they pay," he said, adding the agency works with the public by setting up payment plans if needed.

Beougher said he doesn't like the idea of increasing rates but feels it's warranted at this time.

"We don't raise the rates often but I know this will help us greatly," he said.